Frequently Asked Questions About MDMA Therapy

In recent years, MDMA therapy has emerged as a potential psychiatric treatment in a ketamine clinic setting. Many patients have questions about whether it is appropriate for them as part of a structured mental health care plan by a psychiatrist. The following blog answers some of the most the common questions about MDMA therapy and what you can expect from the treatment process.

What is MDMA therapy?

MDMA therapy, or MDMA-assisted therapy (MDMA-AT), refers to the clinically supervised use of 3,4-methylenedioxymethamphetamine, colloquially known as "ecstasy" or "molly," as part of a comprehensive treatment plan in psychotherapy. Unlike the recreational use of MDMA, this approach follows strict medical and ethical guidelines as laid out by the Food and Drug Administration (FDA). In research settings, the treatment is conducted under the care of a licensed psychiatrist and integrated into a broader psychotherapy treatment plan.

Is MDMA therapy legal?

On a federal level, MDMA therapy is not legal for general medical use in the United States. Its use in psychotherapy is still being researched in clinical trials. In 2017, the FDA granted it "breakthrough therapy" designation for post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), suggesting it may be approved for broader medical use in the future.

As of August 2024, the FDA advisory panel voted against approving MDMA-AT for PTSD and requested additional Phase 3 trials to understand its long-term effects and safety. This means that it is not yet approved for clinical usage and requires further research to address potential for misuse, standardized treatment protocols, and the psychological impacts of MDMA outside of controlled medical environments. At the end of the day, MDMA remains a Schedule I controlled substance.

What can MDMA therapy treat?

Researchers have primarily researched MDMA therapy in the treatment of PTSD and MDD as part of a comprehensive treatment plan. However, they have also considered using MDMA therapy for those with complex trauma, treatment-resistant depression (TRD), and certain anxiety disorders. Before the clinical trial begins, the research team has each patient undergo a comprehensive assessment, including their mental health history, physical health, and current medications.

How does MDMA therapy work?

As explored in clinical trials, MDMA therapy consists of three distinct types of sessions: preparatory, MDMA, and integration sessions. Before the patient undergoes MDMA treatment, they undergo three 90-minute preparatory sessions to educate them about the treatment and build trust in the psychiatric team. They will also work with the psychiatrist to establish clear therapeutic goals.

Then, the patient will move into the active treatment phase. A course of treatment involves two to three MDMA sessions. Most of these treatments last 6-8 hours and are scheduled once a week for 1 month. MDMA sessions typically involve two doses. The first dose is a full dose of 75–125 mg (80–120 mg in the most recent Phase 3 clinical trials). A supplemental dose, half of the initial amount, is offered 90–120 minutes later based on the patient's tolerance and the psychiatrist's professional judgment.

After each MDMA session, the patient will participate in three 90-minute integration sessions for a total of six to nine integration sessions per course of treatment. The first integration session happens the morning after the MDMA session. Meanwhile, the second and third sessions followed at about one-week intervals before the next MDMA session.

Is MDMA therapy safe?

In controlled research studies, patients undergoing MDMA therapy have mild to moderate side effects that do not last long after treatment. The most common side effects include:

• Elevated heart rate or blood pressure
• Feeling anxious, restless, or jittery
• Muscle tightness
• Jaw clenching
• Decreased appetite and nausea
• Excessive sweating or chills
• Chest pain or discomfort
• Blurred vision

It is important to note that MDMA therapy supervised by a licensed psychiatrist is different from taking MDMA recreationally. The potential benefits of MDMA for PTSD and MDD have been demonstrated when taken as directed during a course of psychotherapy.

How is MDMA therapy different from ketamine treatment?

Although both treatments are psychedelic medicines, MDMA therapy and ketamine treatment operate through different neurobiological mechanisms in the human brain. MDMA is a non-traditional psychedelic that primarily stimulates serotonin production. Meanwhile, ketamine targets the glutamate system, leading to rapid symptom relief.

Additionally, MDMA-AT emphasizes that patients engage more during the treatment session, as the open state produced by the medicine encourages them to challenge harmful memories. In contrast, ketamine therapy is quieter and more internal, offering more of a mental reset that allows patients to see and feel things that may have been inaccessible before. Another important distinction is that ketamine therapy is already FDA-approved for limited clinical usage, while MDMA therapy is still restricted to clinical research trials.

Schedule a consultation at our Myrtle Beach office

Do you have further questions about the future of MDMA therapy? The Future Psych Ketamine Clinics team is here to answer them. Call our Myrtle Beach office to learn more or to schedule a consultation.

Request an appointment here: https://mb.futurepsychsolutions.com or call Future Psych Ketamine Clinics at (843) 788-9718 for an appointment in our Myrtle Beach office.

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